The 1 September 2018 marks one month since the declaration of the Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces, Democratic Republic of the Congo. The Ministry of Health, WHO and partners have made progress in response to the outbreak during this time. Recent trends (Figure 1) suggest that control measures are working; however, these trends must be interpreted with caution.

Since our last situation report on 28 August 2018 (External situation report 4), an additional 11 new EVD cases (8 confirmed and 3 probable) and seven new deaths have been reported. Nine other suspected cases are currently under investigation to confirm or exclude EVD.

As of 2 September 2018, a total of 122 confirmed and probable EVD cases, including 82 deaths, have been reported. Of the 122 cases, 91 are confirmed and 31 are probable. Of the 82 deaths, 51 occurred in confirmed cases. Of the 113 confirmed and probable cases with known age and sex, females account for 55% (n=62), and the largest proportion (26%, n=29) of cases were aged 35-44 years (Figure 2). A total of 16 health workers (15 confirmed and 1 probable) have been affected, of which one has died. All health workers’ exposures occurred in health facilities outside the dedicated Ebola Treatment Centres (ETCs). As of 1 September 2018, 15 patients were being managed at Mangina ETC (6 confirmed cases and 4 suspected) and in Beni (5 confirmed cases).

The epicentre of the outbreak remains Mabalako Health Zone in North Kivu Province, reporting 70% (86/122) of all cases and 76% (62/82) deaths, including 65 confirmed and 21 probable cases (Figure 3). Additionally, four other health zones in North Kivu Province and one in Ituri Province have reported confirmed and probable cases (Table 1 and Figure 2). Of concern is an apparent increase in transmission in Beni Health Zone, where the number of confirmed and probable cases has increased from eight on 23 August 2018 to 19 cases on 2 September 2018.

Since the beginning of the outbreak, a cumulative total of 4296 contacts have been listed, of which 2512 (58.5%) remain under surveillance as of 2 September 2018. During the past seven days, daily follow-up was completed for 92-97% of these contacts.

The Ministry of Health, WHO and partners are monitoring and investigating alerts in other provinces in the Democratic Republic of the Congo and in neighbouring countries. Since the last report was published, alerts were investigated in several provinces of the Democratic Republic of the Congo as well as in Uganda, Rwanda and the Central African Republic, and, to date, EVD has been ruled out in all these alerts.